Abstract
AimGiven the need for data to inform public health messaging to mitigate the COVID-19 pandemic, this national survey sought to assess the state of COVID-19-related knowledge, beliefs, mental health, substance use changes, and behaviors among a sample of U.S. adults.Subject and methodsIn the period March 20–30, 2020, we collected data on COVID-19-related knowledge, awareness and adoption of preventive practices, depression and anxiety (Patient Health Questionnaire-4), stress (Impact of Event Scale-6), pessimism, and tobacco and alcohol use. Differences between age groups (18–39 years, 40–59 years and ≥ 60 years) were tested using Pearson’s chi-squared tests or ANOVAs; associations between drinking and smoking and depression, anxiety, and stress were tested using adjusted logistic regression models.ResultsApproximately half of the sample (NTotal = 6391) were 50–69 years old and 58% were female. COVID-19 knowledge (mean = 12.0; SD = 1.2) and protective practice awareness (mean = 9.1; SD = 0.8) were high. Among respondents, 44% had a score consistent with depression and anxiety (PHQ-4 score ≥ 6), and 52% reported high stress scores (≥ median of 1.33). COVID-19-related anxiety and depression were associated with increased drinking (AOR = 1.79; 95% CI = 1.49, 2.15) and smoking (AOR = 2.17; 95% CI = 1.64, 2.88). High stress scores were also associated with increased drinking (AOR = 1.80; 95% CI = 1.49, 2.17, p < 0.001) and smoking (AOR = 1.75; 95% CI = 1.31, 2.33).ConclusionsIn spite of high knowledge levels, important gaps were identified. High prevalence of poor mental health outcomes and associated increases in drinking and smoking warrant ongoing risk communications tailoring to effectively disseminate information and expanding psychosocial services, particularly via telehealth, to mitigate the negative mental health impact of COVID-19.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10389-021-01564-4.
Highlights
While many states have enacted social distancing measures to slow viral transmission, there is limited empirical research with regard to people’s knowledge, beliefs, and perceptions related to COVID-19 that
Respondents took a median of 10.9 min [interquartile range (IQR) = 9.0, 13.4] to complete the full survey
Another gap was the relatively low awareness about alcohol-based hand sanitizers as a protective practice. These findings suggest that while adults are largely cognizant of accurate information about COVID-19 and preventive practices, some gaps remain to be addressed
Summary
Global Health Program, School of Global Public Health, New York University, New York, NY, USAThe novel coronavirus disease (COVID-19) has rapidly emerged as a pandemic, precipitating the largest global health and economic crisis in recent history (World Health Organization 2020a). With relatively high morbidity and mortality rates (Wilson et al 2020), among older adults (Bai et al 2020; Chan et al 2020; Rothe et al 2020), COVID-19 has already inflicted myriad adverse health, social, and economic consequences, and exacerbated existing health inequities. While many states have enacted social distancing measures to slow viral transmission, there is limited empirical research with regard to people’s knowledge, beliefs, and perceptions related to COVID-19 that. Lacking are data on COVID-19-related anxiety, depression, and substance use, which may adversely affect adoption and sustainment of mitigation behaviors (Brooks et al 2020). To optimize the development of effective public health messaging, it is critical to identify gaps in COVID-19-related knowledge, beliefs, and mitigation behaviors
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